居家失能老人压力性损伤风险评估量表的编制及信效度检验

doi:10.3761/j.issn.1672-9234.2023.10.017

摘要/Abstract

摘要：

目的编制居家失能老人压力性损伤风险评估量表并进行信效度检验。方法以SHEL模型为指导[包括软件（soft）、硬件（hard）、环境（environment）、人（liveware）]，通过文献回顾建立量表条目池，根据德尔菲专家咨询形成量表初稿，采用便利抽样法对384例居家失能老人进行数据收集，通过项目分析、信效度检验、受试者工作特征曲线及危险分级进行统计分析，并依据专家咨询中的相关性评分计算量表的内容效度指数。结果 2轮咨询专家积极系数分别为97%（33/34）、100%（33/33），权威系数均为0.86，肯德尔和谐系数分别为0.272、0.240。形成的居家失能老人压力性损伤风险评估量表包含个体特征、照护环境、照护支持和器具使用4个维度、14个条目。条目水平的内容效度指数为0.82~1.00，量表水平的内容效度指数为0.94；探索性因子分析共提取4个公因子，累积方差解释率为78.900%；验证性因子分析显示模型拟合良好；量表的Cronbach’s α系数为0.825，量表总的重测信度为0.854；量表的最佳临界值为30分，受试者工作特征曲线下面积为0.916，危险分级为30~33分为低风险，34~38分为中风险，>38分为高风险。结论居家失能老人压力性损伤风险评估量表具有良好的信效度，可帮助护理人员有效识别居家失能老人压力性损伤风险，为后续提高照护质量及降低压力性损伤发生率提供依据。

关键词: 老年人, 危险性评估, 问卷调查, 失能, 压力性损伤, 信度, 效度

Abstract:

Objective To develop a scale of pressure injury risk assessment for the home-based disabled elderly and to examine its reliability and validity. Methods Following SHEL model，the item pool of the scale was established through literature review. The first draft of the scale was developed according to Delphi expert consultation. The convenient sampling method was used in collect data from 384 home-based disabled elderly. Statistical analysis was conducted through item analysis，reliability and validity test，subject work characteristic curve and risk classification. The content validity index was calculated according to the correlation score in expert consultation. Results The positive coefficients of experts（n=34） in the two rounds of correspondence were 97% and 100% respectively. The scale of care risk assessment for home-based disabled elderly with pressure injury included 14 items in four dimensions，namely individual characteristics，care environment，care support and appliance employment. Meanwhile，the authority coefficients were 0.86，and the Kendall coefficients were 0.272 and 0.240 respectively. The item-level content validity index was 0.82—1.00，and the scale-level content validity index was 0.94. Exploratory factor extracted four common factors，and the cumulative variance interpretation rate reached 78.900%. Confirmatory factor analysis showed that the model fitted well. The Cronbach’s α coefficient of the scale was 0.825，and retest reliability of the scale was 0.854. The best critical value of the scale was 30 points. The area under the receiver operator characteristic curve reached 0.916，where the risk score of 30—33 points for low risk，34—38 points for medium risk，and >38 points for high risk. Conclusion The scale has good reliability and validity，and can be used for the assessment of the risk of pressure injury in the home-based disabled elderly，so as to provide the basis for improving the quality of care and reducing the incidence of stress injure for home-based disabled elderly.

Key words: Aged, Risk Assessment, Questionnaires, Disabled, Pressure injury, Reliability, Validity

武晓茹, 颜巧元. 居家失能老人压力性损伤风险评估量表的编制及信效度检验[J]. 中华护理教育, 2023, 20(10): 1253-1260.

WU Xiaoru, YAN Qiaoyuan. Development and validation of a pressure injury risk scale for the home-based disabled elderly[J]. Chinese Journal of Nursing Education, 2023, 20(10): 1253-1260.

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